Summary
The Pennsylvania Department of Human Services issued an updated School-Based ACCESS Program (SBAP) provider handbook dated November 2017 for local education agencies enrolled in the Medical Assistance Program. The handbook was revised to reflect procedure code updates based on the 2017 HCPCS updates effective August 7, 2017, and to update webpage links. SBAP providers are to follow the requirements in the handbook for participation and billing procedures for Medical Assistance reimbursement.
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What to do
Action · 7 steps
01Already effective 2017-11-22: SBAP providers should follow the requirements in the updated SBAP provider handbook dated November 2017 for participation requirements and billing procedures.
02Obtain the prescription or Medical Practitioner Authorization Form signature date before the date of the Medical Assistance service being billed, and renew it at least annually or whenever the health-related services in the IEP change.
03Record exact start and end times on provider logs, because rounding up service minutes is prohibited.
04Submit direct service and special transportation claims to DHS within 180 days from the day the service was rendered.
05Obtain the one-time parental consent before accessing public benefits and provide the annual parental notification.
06Verify the student's Medical Assistance eligibility on each date of service and retain records for at least four years.
07Check the SBAP webpage on the DHS website, where DHS will post all future updates to the handbook.
Codes mentioned
T1999T1003T1002T1502T1019T1023925079250892523S915297166971689753097533971629716497110991729079190832908539615096151H2027H0031H0046A0434
Original notice
351702 Merge attachment
pa.gov · Always check the source before changing claims.
Related changes
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Related policy hubs
Pennsylvania Medicaid (DHS) policiesPA policy changesPediatricsSpeech TherapyOccupational TherapyPhysical TherapyAudiologyPsychiatryCode T1999Code T1003Code T1002Code T1502Code T1019Code T1023Code 92507Code 92508Code 92523Code S9152Code 97166Code 97168Code 97530Code 97533Code 97162Code 97164Code 97110Code 99172Code 90791Code 90832Code 90853Code 96150Code 96151Code H2027Code H0031Code H0046Code A0434